The goal of this proposal is to reduce the prevalence of chronic lung disease through smoking cessation techniques introduced during comprehensive health care. We shall study patients attending the Given Health Care Center for a comprehensive examination who smoke one or more cigarettes a day. We shall examine the effectiveness of a smoking cessation program which includes: personal counseling at the time of the comprehensive examination on individual risk, the benefits of stopping smoking and specific ways to quit; maintenance counseling concerning the social and emotional antecedents of relapse and the skills to cope with these; letters from the comprehensive care physicians reinforcing the messages of these counseling sessions; and referral to self-help or group smoking cessation services and home counseling on individual risk and quitting techniques. The major objective is to reduce the prevalence of cigarette smoking by 35% over the course of two years. Specific aims of the proposal are to determine the effectiveness of the smoking cessation program in comparison to usual comprehensive care; the extent to which motivations and intentions to stop smoking, the number of attempts to stop, and the success rate of attempts to stop are increased by the counseling; the effectiveness of the smoking cessation counseling in relation to respiratory, cardiac and functional health status findings; and to measure days of sickness, days off work, and the use of health care facilities by participants in the study. After the initial counseling and referral to smoking cessation aids, smoking behavior and attempts to quit will be ascertained at three months and one year. On each occasion, referral to smoking cessation aids will be made, and home counseling will be offered at the first annual follow-up visit. Further maintenance counseling will be provided to those who succeed in quitting. The outcome of the program will be assessed two years after the comprehensive care examination. Smoking behavior will be measured by self-report and by salivary thiocyanate concentration.